Research paperSuicide in males and females with cardiovascular disease and comorbid depression

- Among people who died by suicide, CVD and depression was more common among males.
- Individuals with CVD and depression were more likely to have a past suicide attempt.
- Bereavement or financial stressor was common in individuals with CVD and depression.
- Females with CVD and depression were more likely to die by self-poisoning.
- Males with CVD and depression were more likely to die by shooting.

BackgroundMyocardial infarction (MI) has been associated with an increased risk of suicide, further increased among individuals with a comorbid psychiatric illness. A paucity of studies have examined details of suicide among individuals with cardiovascular disease (CVD) and comorbid depression. We aimed to compare demographic, clinical and suicide-specific characteristics between suicide victims with CVD with depression (CVD+D) and without comorbid depression (CVD−D).MethodsCoroner data on suicide decedents with CVD (n=413) occurring in Toronto, Canada from 1998 to 2012 were collected. Characteristics were compared between the CVD+D and CVD-D groups. Regression analysis examined for gender differences in these groups.ResultsCVD+D subjects compared to CVD−D were more likely to have had a past suicide attempt (p=0.008), and to have experienced a bereavement (p=0.008) or financial stressor (p=0.005) in the past year. Each of these variables remained significantly associated with the presence of depression after the regression analysis. Within the CVD+D group, females were more likely to die from suicide by self-poisoning (p<0.0001) and males by shooting (p=0.001).LimitationsPsychological autopsies were not available. The definition of CVD was broad and the accuracy of its diagnosis could not be confirmed.ConclusionIndividuals with CVD+D who died from suicide had significant differences in clinical characteristics and specific stressors compared to those without depression. These data may help to better characterize suicide risk and prevention in this vulnerable population.